Hypoglossal Nerve Implants for Sleep Apnoea

Advanced, mask-free treatment for patients who cannot tolerate CPAP.

Hypoglossal nerve stimulation offers an innovative option for people with obstructive sleep apnoea who struggle with CPAP. Mr Ryan Cheong is a national leader in this field, performing UK-first implant procedures and providing comprehensive assessment for both Inspire and Genio Nyxoah implant systems.

Understanding Hypoglossal Nerve Implants

Hypoglossal nerve implants are medically implanted devices designed to reduce airway collapse during sleep. They work by gently stimulating the hypoglossal nerve — the nerve that controls tongue movement — to keep the airway open with each breath.

Unlike CPAP machines, which rely on air pressure, implant systems work naturally with the body’s own muscle activity. They are silent, mask-free and operate automatically during sleep.

These implants are typically considered for people with:

Moderate to severe obstructive sleep apnoea
Difficulty tolerating CPAP
Airway collapse patterns suitable for stimulation technology

The two devices currently available in the UK are:

Inspire Upper Airway Stimulation system
Genio Nyxoah nerve stimulation system

Who is Implant Therapy Is Suitable For?

Not every patient with sleep apnoea will benefit from an implant. Suitability depends on several key factors:

Diagnosis and severity

Moderate to severe obstructive sleep apnoea, confirmed by sleep study.

Airway anatomy

Specific collapse pattern — typically where the tongue or soft palate contributes to obstruction.
Implant therapy is not suitable for patients with complete concentric collapse of the soft palate.

CPAP intolerance

Difficulty using CPAP due to discomfort, claustrophobia, mask fit issues or inability to maintain long-term adherence.

General health

Ability to attend follow-up appointments for device programming and monitoring.

Lifestyle & personal preference

Patients wanting a solution that is discreet, quiet and requires minimal nightly setup.

Each candidate undergoes a structured clinical evaluation to confirm implant suitability.

How We Assess for Implant Treatment

Assessment includes a combination of airway evaluation, clinical examination and diagnostic testing.

Airway examination

A full ENT assessment of the nose, throat and tongue base helps identify structural contributors to airway collapse.

Sleep study

Confirms diagnosis, measures severity and provides baseline data to determine whether implant therapy is appropriate.

Drug-Induced Sleep Endoscopy (DISE)

DISE is a crucial step in implant assessment.
It allows Mr Ryan Cheong to observe the airway during sleep-like conditions, showing exactly where and how the airway collapses.
DISE identifies whether the collapse pattern is compatible with hypoglossal nerve stimulation.

Treatment planning

If the patient is a suitable candidate, Mr Cheong will discuss the implant options — Inspire or Genio Nyxoah — including:

Device differences
Activation timeline
Follow-up programming
Expected results
Risks and recovery

→ Learn more about Sleep Studies

Treatment Options: Inspire & Genio Nyxoah Implants

Inspire Upper Airway Stimulation

The Inspire system includes:

A small pulse generator placed in the chest
A sensing lead that monitors breathing
A stimulation lead connected to the hypoglossal nerve

As you breathe in, the device activates the tongue muscles to prevent collapse. It is switched on at night via a handheld remote.

Genio Nyxoah Implant

The Genio system is fully implanted under the chin with no chest component. It uses bilateral nerve stimulation and is activated through an external patch worn under the chin.
This device appeals to patients who prefer a single-implant approach with less internal hardware.

The procedure

Minimal incisions
Light activity recovery within days

Activation & follow-up

Device activation usually occurs 4-8 weeks after surgery
Multiple programming sessions help optimise settings
Patients often begin to notice improvements within the first few weeks of active therapy

Expected results

Many suitable patients experience:

Reduced apnoea events
Quieter sleep
Improved daytime energy
Better quality of life
High long-term adherence compared to CPAP

Results vary depending on airway anatomy and collapse pattern — which is why DISE-directed assessment is essential.

Internal link:
→ View Sleep Apnoea Treatment Options

Mr Cheong’s Expertise with Hypoglossal Nerve Implants

Mr Ryan Cheong is one of the UK’s most experienced surgeons in hypoglossal nerve stimulation.
He performed:

The first Genio Nyxoah implant in the UK
The first female Inspire implant in the UK

These achievements reflect his leadership in developing new pathways for patients who cannot tolerate CPAP.

He is heavily involved in national discussions around expanding access to implant therapy and contributes to training programmes for other surgeons through ENT-UK and international sleep surgery societies.

His work in implant surgery has been widely covered by:

BBC
Sky News
The Guardian
The Times
The Independent
Daily Mail
Metro
The Mirror

→ View full media coverage

Frequently Asked Questions

Is hypoglossal nerve stimulation safe?

Yes. Both Inspire and Genio Nyxoah implants are approved for use and have undergone extensive clinical evaluation. Suitability is confirmed through detailed assessment.

Does the implant hurt when it activates?

Most patients describe the sensation as mild stimulation that becomes unnoticeable over time.

Will insurance or self-pay packages cover the implant?

Availability depends on individual insurance policies and clinic pathways.

How long does the battery last?

Inspire devices typically last around 10 years before replacement. Genio uses an external power source, so replacement is not needed in the same way.

Can the implant be removed?

Yes. Removal is possible if required, though most patients continue treatment long-term.

Take the Next Step Towards Better Sleep

Schedule a consultation with Mr Ryan Cheong to understand your symptoms and explore appropriate treatment options.